REZA SAM BORHANI DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108035

License Status

NOT RENEWED

Business

First Name

REZA

Middle

SAM

Last Name

BORHANI

Suffix

Business Name

REZA SAM BORHANI DO

Original Issue Date

10/17/2002

Effective Date

10/17/2002

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

10/09/2006